UiPath is a federal contractor or subcontractor subject to certain governmental recordkeeping and reporting requirements for the administration of civil right laws and regulations. Employment decisions are made on the basis of job-related criteria without regard to race, ethnicity, color, religion, sex, sexual orientation, gender identity, marital status, age, genetic information, national origin, disability, military, or veteran status, or any other classification protected by applicable law.

We invite all applicants to voluntarily self-identify their race, ethnicity, and gender. Submission of the information on this form is strictly voluntary and refusal to provide it will not subject you to any adverse treatment. Information obtained will be retained in a confidential file and separate from personnel records. This information may only be used in accordance with the provision of applicable federal laws, executive orders, and regulations. If you want more information about any of the sections, please check with a company representative.

Gender

Race

Hispanic or Latino

A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.

White (Not Hispanic or Latino)

A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

Black or African American (Not Hispanic or Latino)

A person having origins in any of the black racial groups of Africa.

Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino)

A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

Asian (Not Hispanic or Latino)

A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

American Indian or Alaska Native (Not Hispanic or Latino)

A person having origins in any of the original peoples of North and South America (including Central America), and who maintain tribal affiliation or community attachment.

Two or More Races (Not Hispanic or Latino)

All persons who identify with more than one of the above five races.

Decline to self-identify

Self-identification of veteran status (Completion is voluntary and will not subject you to adverse treatment)

UiPath is a Government contractor subject to the Section 4212 of the Vietnam Era Veterans’ Readjustment Assistance Act of 1974, as amended by the Jobs for Veterans Act of 2002, which requires Government contractors to take affirmative action to employ and advance in employment: (1) Disabled veterans – A veteran who served on active duty in the U.S. military and is entitled to disability compensation (or who but for the receipt of military retired pay would be entitled to disability compensation) under laws administered by the Secretary of Veterans Affairs, or was discharged or released from active duty because of a service-connected disability; (2) Recently separated veteran – A veteran separated during the three-year period beginning on the date of the veteran's discharge or release from active duty in the U.S military, ground, naval, or air service; (3) Active duty wartime or campaign badge veteran – A veteran who served on active duty in the U.S. military during a war, or in a campaign or expedition for which a campaign badge was authorized under the laws administered by the Department of Defense; (4) Armed forces service medal veteran – A veteran who, while serving on active duty in the U.S. military ground, naval, or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985 (61 Fed. Reg. 1209). If you believe that you belong to any of the categories of protected veterans, please indicate by making the appropriate selection.

Veteran status

Self-identification of disability (Completion is voluntary and will not subject you to adverse treatment)

Form CC-305 / OMB Control Number 1250-0005 / Expires 1/31/2020

Why are you being asked to complete this form?

Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities. To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way.

If you already work for us, your answer will not be used against you in any way. Because a person may become disabled at any time, we are required to ask all of our employees to update their information every five years. You may voluntarily self-identify as having a disability on this form without fear of any punishment because you did not identify as having a disability earlier.

How do I know if I have a disability?

You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition. Disabilities include, but are not limited to:

Blindness

Deafness

Cancer

Diabetes

Epilepsy

Autism

Cerebral palsy

HIV/AIDS

Schizophrenia

Muscular dystrophy

Bipolar disorder

Major depression

Multiple sclerosis (MS)

Missing limbs or partially missing limbs

Post-traumatic stress disorder (PTSD)

Obsessive compulsive disorder

Impairments requiring the use of a wheelchair

Intellectual disability (previously called mental retardation)

Reasonable Accommodation Notice

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.

Section 503 of the Rehabilitation Act of 1973, as amended. For more information about this form or the equal employment obligations of Federal contractors, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.

PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.

Disability status

Your name

Today’s date

Note: Name and date are only required if you filled out Disability status.